Mixed
Higher appendicular skeletal muscle mass (ASMI) is independently associated with lower all-cause mortality, and accounting for muscle mass shifts the BMI associated with the lowest risk of death downward toward the normal range (22-25 kg/m2).
Do not rely on BMI alone to assess your health risk. If you have a 'normal' BMI but low muscle mass, your mortality risk may be higher than someone with a 'high' BMI but preserved muscle mass. Prioritize resistance training and protein intake to build or maintain skeletal muscle mass, as this is an independent protective factor against death, regardless of your weight.
Higher ASMI was independently associated with a reduced risk of death (HR 0.82 per 1 kg/m2 (95% CI 0.73–0.92)). ... After accounting for muscle mass, the level of BMI associated with the greatest survival shifts downward toward the normal range.
Why this rating
Large, nationally representative cohort (NHANES, n=11,687) with objective DEXA body composition measurements and long-term mortality follow-up (median 9.3 years), though observational design limits causal inference.
Source
Muscle mass, BMI, and mortality among adults in the United States: A population-based cohort study
Matthew K. Abramowitz et al. · PLoS ONE · 2018
DOI 10.1371/journal.pone.0194697
Related findings · Mixed
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